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General NPI Number Information
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NPI Number | 1134213598
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Entity Type | Organization
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Legal Business Name | INTERSCIENCE DIAGNOSTIC LABORATORIES,INC
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Dates
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Enumeration Date | 10/02/2006
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Last Update Date | 09/24/2021
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Provider Practice Location Address
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Address Line | 4218 AMBOY RD
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City | STATEN ISLAND
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State | NY
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Zip | 10308-2379
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Country | US
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Telephone | 718-698-5461
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Fax | 718-698-4517
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Provider Business Mailing Address
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Address Line | 4218 AMBOY RD
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City | STATEN ISLAND
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State | NY
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Zip | 10308-2379
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Country | US
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Telephone | 718-698-5461
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Fax | 718-698-4517
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Authorized Official
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Title or Position | ADMINISTRATION
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Name | MRS. SADIA MALIK
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Credential |
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Telephone | 718-698-5461
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number | PFI3807
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License Number State | NY
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